Child Care centers are inspected at least twice per year by an Environmental Health Specialist. During these inspections, the Environmental Health Specialist observe and communicates with facility personnel about procedures related to diaper changing, food service and preparation, storage of chemicals and medicine as well as general sanitation. Child Care centers receive a score based on the number of violations found during the inspection. There is a demerit system in which a classification of superior, approved, provisional or disapproved is assigned based on the demerits received.